166 THE INTERNAL SECRETIONS—1920 
unknown chemical changes necessary to continued life 
and the maintenance of the stability of the nucleus of 
the protein molecule which must be preserved in its 
colloid state during life. 
In consideration of these facts the mere maintenance 
of the circulation assumes a vast importance. 
In our routine chemical study, after we have elimi- 
nated focal infection, errors in diet, have regulated the 
rest and exercise, and have narrowed our study to that 
great field of investigation—the patient him (or her) 
self, who does not get well, but lingers in that unsatis- 
factory state that makes the family wish “Aunt Belle 
would get well or something”—then we may turn to the 
study of metabolism as affected by the glands of inter- 
nal excretion, with the hope of doing something helpful. 
Even the laity is well aware of the dangers of high 
blood pressure, but the multitude of ways in which a 
low pressure may do damage and the great number of 
patients suffering from this condition, is perhaps un- 
derestimated by physicians. Following the epidemic 
of a year and a half ago, the “flu” left many of its vic- 
tims weak, exhausted, unable to work, without their 
accustomed ‘‘pep.” They poured through the physi- 
cians’ offices in a steady stream. Most of these people 
had a blood pressure below normal, and responded 
promptly either to adrenal or to suitable pluriglandn- 
lar therapy. This experience has been a great eye- 
opener to many physicians, and has stimulated investi- 
gation in a great variety of conditions in which we may 
find the same symptoms, and the relief of which goes 
a long way to turn the tide in favor of healthy meta- 
bolism. Jt is well worth while to think over the changes 
attendant upon and conditioned on a lowered blood 
pressure. 
Such conditions favor a decrease in the cellular oxi- 
dation and slow the blood stream, with, therefore, an 
accumulation of metabolites in the fluids and tissues. 
